﻿<%@ Page Title="" Language="C#" MasterPageFile="~/Site.Master" AutoEventWireup="true" CodeBehind="Register.aspx.cs" Inherits="HealthInsuranceMgm.Register" %>
<asp:Content ID="Content1" ContentPlaceHolderID="ContentPlaceHolder1" runat="server">
    <form id="form1" runat="server">
    <table style="width: 100%">
        <tr>
            <td style="padding: 2px; margin: 2px; height: 19px; font-size: x-large; color: #008000;" 
                align="center" colspan="4" bgcolor="#CCFF99">
                REGISTER</td>
        </tr>
        <tr>
            <td style="height: 19px" width="20%">
                </td>
            <td style="height: 19px" colspan="2" width="30%">
                <asp:Label ID="lblMessage" runat="server" ForeColor="Red"></asp:Label>
                </td>
            <td style="height: 19px" width="30%">
                </td>
        </tr>
        <tr>
            <td style="height: 19px" width="20%">
                &nbsp;</td>
            <td style="height: 19px" colspan="2" width="30%">
                &nbsp;</td>
            <td style="height: 19px" width="30%">
                &nbsp;</td>
        </tr>
        <tr>
            <td style="height: 19px">
                Desination</td>
            <td style="height: 19px" colspan="2">
                <asp:TextBox ID="txtDesination" runat="server" Width="230px"></asp:TextBox>
            </td>
            <td style="height: 19px; color: #FF0000;">
                *
                <asp:RequiredFieldValidator ID="RequiredFieldValidator1" runat="server" 
                    ControlToValidate="txtDesination" ErrorMessage="Require Type" ForeColor="Red"></asp:RequiredFieldValidator>
                </td>
        </tr>
        <tr>
            <td style="height: 19px">
                Join Date</td>
            <td style="height: 19px" colspan="2">
                <asp:TextBox ID="txtJoinDate" runat="server" ReadOnly="True" Width="230px"></asp:TextBox>
            </td>
            <td style="height: 19px">
                &nbsp;</td>
        </tr>
        <tr>
            <td style="height: 19px">
                Salary</td>
            <td style="height: 19px" colspan="2">
                <asp:TextBox ID="txtSalary" runat="server" Width="230px"></asp:TextBox>
            </td>
            <td style="height: 19px; color: #FF0000;">
                *
                <asp:RequiredFieldValidator ID="RequiredFieldValidator3" runat="server" 
                    ControlToValidate="txtSalary" ErrorMessage="Require Type" ForeColor="Red"></asp:RequiredFieldValidator>
            </td>
        </tr>
        <tr>
            <td style="height: 19px">
                First Name</td>
            <td style="height: 19px" colspan="2">
                <asp:TextBox ID="txtFirstName" runat="server" Width="230px"></asp:TextBox>
            </td>
            <td style="height: 19px; color: #FF0000;">
                *
                <asp:RequiredFieldValidator ID="RequiredFieldValidator4" runat="server" 
                    ControlToValidate="txtFirstName" ErrorMessage="Require Type" ForeColor="Red"></asp:RequiredFieldValidator>
            </td>
        </tr>
        <tr>
            <td style="height: 19px">
                Last Name</td>
            <td style="height: 19px" colspan="2">
                <asp:TextBox ID="txtLastName" runat="server" Width="230px"></asp:TextBox>
            </td>
            <td style="height: 19px; color: #FF0000;">
                *
                <asp:RequiredFieldValidator ID="RequiredFieldValidator5" runat="server" 
                    ControlToValidate="txtLastName" ErrorMessage="Require Type" ForeColor="Red"></asp:RequiredFieldValidator>
            </td>
        </tr>
        <tr>
            <td style="height: 19px">
                User Name</td>
            <td style="height: 19px" colspan="2">
                <asp:TextBox ID="txtUserName" runat="server" Width="230px"></asp:TextBox>
            </td>
            <td style="height: 19px; color: #FF0000;">
                *
                <asp:RequiredFieldValidator ID="RequiredFieldValidator6" runat="server" 
                    ControlToValidate="txtUserName" ErrorMessage="Require Type" ForeColor="Red"></asp:RequiredFieldValidator>
                </td>
        </tr>
        <tr>
            <td style="height: 19px">
                Password</td>
            <td style="height: 19px" colspan="2">
                <asp:TextBox ID="txtPassword" runat="server" TextMode="Password" Width="230px"></asp:TextBox>
            </td>
            <td style="height: 19px; color: #FF0000;">
                *
                <asp:RequiredFieldValidator ID="RequiredFieldValidator7" runat="server" 
                    ControlToValidate="txtPassword" ErrorMessage="Require Type" ForeColor="Red"></asp:RequiredFieldValidator>
            </td>
        </tr>
        <tr>
            <td style="height: 19px">
                RePassword</td>
            <td style="height: 19px" colspan="2">
                <asp:TextBox ID="txtRePassword" runat="server" TextMode="Password" 
                    Width="230px"></asp:TextBox>
            </td>
            <td style="height: 19px; color: #FF0000;">
                *
                <asp:RequiredFieldValidator ID="RequiredFieldValidator8" runat="server" 
                    ControlToValidate="txtRePassword" Display="Dynamic" ErrorMessage="Require Type" 
                    ForeColor="Red"></asp:RequiredFieldValidator>
&nbsp;&nbsp;&nbsp;
                <asp:CompareValidator ID="CompareValidator1" runat="server" 
                    ControlToCompare="txtPassword" ControlToValidate="txtRePassword" 
                    Display="Dynamic" ErrorMessage="CompareValidator" ForeColor="Red">RePassword not match Password!</asp:CompareValidator>
            </td>
        </tr>
        <tr>
            <td style="height: 19px">
                Address</td>
            <td style="height: 19px" colspan="2">
                <asp:TextBox ID="txtAddress" runat="server" TextMode="MultiLine" Width="230px"></asp:TextBox>
            </td>
            <td style="height: 19px; color: #FF0000;">
                *
                <asp:RequiredFieldValidator ID="RequiredFieldValidator9" runat="server" 
                    ControlToValidate="txtAddress" ErrorMessage="Require Type" ForeColor="Red"></asp:RequiredFieldValidator>
            </td>
        </tr>
        <tr>
            <td style="height: 19px">
                ContactNo</td>
            <td style="height: 19px" colspan="2">
                <asp:TextBox ID="txtContactNo" runat="server" Height="22px" Width="230px"></asp:TextBox>
            </td>
            <td style="height: 19px">
                &nbsp;</td>
        </tr>
        <tr>
            <td style="height: 19px">
                State</td>
            <td style="height: 19px" colspan="2">
                <asp:TextBox ID="txtState" runat="server" Width="230px"></asp:TextBox>
            </td>
            <td style="height: 19px">
                &nbsp;</td>
        </tr>
        <tr>
            <td style="height: 19px">
                Country</td>
            <td style="height: 19px" colspan="2">
                <asp:TextBox ID="txtCountry" runat="server" Width="230px"></asp:TextBox>
            </td>
            <td style="height: 19px">
                &nbsp;</td>
        </tr>
        <tr>
            <td style="height: 19px">
                City</td>
            <td style="height: 19px" colspan="2">
                <asp:TextBox ID="txtCity" runat="server" Width="230px"></asp:TextBox>
            </td>
            <td style="height: 19px">
                &nbsp;</td>
        </tr>
        <tr>
            <td style="height: 20px">
                Check Capcha</td>
            <td style="height: 20px" colspan="2">
                <asp:TextBox ID="txtInputString" runat="server"></asp:TextBox>
                <asp:Image ID="captchaImage" runat="server" />
                <asp:ImageButton ID="imbReLoad" runat="server" 
                    ImageUrl="~/images/ReloadImage.jpg"  />
            </td>
            <td style="height: 20px">
                <asp:Label ID="lblCapcha" runat="server" ForeColor="Red"></asp:Label>
                </td>
        </tr>
        <tr>
            <td style="height: 19px">
                &nbsp;</td>
            <td style="height: 19px" width="10%">
                <asp:Button ID="btnRegister" runat="server" Text="Register" Width="85px" />
            </td>
            <td style="height: 19px">
                <asp:Button ID="btnReset" runat="server" Text="Reset" Width="85px" />
            </td>
            <td style="height: 19px">
                &nbsp;</td>
        </tr>
        </table>
    </form>
</asp:Content>
